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Thomas M, Rakesh D, Whittle S, Sheridan M, Upthegrove R, Cropley V. The neural, stress hormone and inflammatory correlates of childhood deprivation and threat in psychosis: A systematic review. Psychoneuroendocrinology 2023; 157:106371. [PMID: 37651860 DOI: 10.1016/j.psyneuen.2023.106371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/20/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023]
Abstract
Childhood adversity increases the risk of developing psychosis, but the biological mechanisms involved are unknown. Disaggregating early adverse experiences into core dimensions of deprivation and threat may help to elucidate these mechanisms. We therefore systematically searched the literature investigating associations between deprivation and threat, and neural, immune and stress hormone systems in individuals on the psychosis spectrum. Our search yielded 74 articles, from which we extracted and synthesized relevant findings. While study designs were heterogeneous and findings inconsistent, some trends emerged. In psychosis, deprivation tended to correlate with lower global cortical volume, and some evidence supported threat-related variation in prefrontal cortex morphology. Greater threat exposure was also associated with higher C-reactive protein, and higher and lower cortisol measures. When examined, associations in controls were less evident. Overall, findings indicate that deprivation and threat may associate with partially distinct biological mechanisms in the psychosis spectrum, and that associations may be stronger than in controls. Dimensional approaches may help disentangle the biological correlates of childhood adversity in psychosis, but more studies are needed.
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Affiliation(s)
- Megan Thomas
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia.
| | - Divyangana Rakesh
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia; Neuroimaging Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia
| | - Margaret Sheridan
- Department of Psychology & Neuroscience, University of North Carolina, United States
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, United Kingdom; Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, United Kingdom
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia
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Murphy F, Nasa A, Cullinane D, Raajakesary K, Gazzaz A, Sooknarine V, Haines M, Roman E, Kelly L, O'Neill A, Cannon M, Roddy DW. Childhood Trauma, the HPA Axis and Psychiatric Illnesses: A Targeted Literature Synthesis. Front Psychiatry 2022; 13:748372. [PMID: 35599780 PMCID: PMC9120425 DOI: 10.3389/fpsyt.2022.748372] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Studies of early life stress (ELS) demonstrate the long-lasting effects of acute and chronic stress on developmental trajectories. Such experiences can become biologically consolidated, creating individual vulnerability to psychological and psychiatric issues later in life. The hippocampus, amygdala, and the medial prefrontal cortex are all important limbic structures involved in the processes that undermine mental health. Hyperarousal of the sympathetic nervous system with sustained allostatic load along the Hypothalamic Pituitary Adrenal (HPA) axis and its connections has been theorized as the basis for adult psychopathology following early childhood trauma. In this review we synthesize current understandings and hypotheses concerning the neurobiological link between childhood trauma, the HPA axis, and adult psychiatric illness. We examine the mechanisms at play in the brain of the developing child and discuss how adverse environmental stimuli may become biologically incorporated into the structure and function of the adult brain via a discussion of the neurosequential model of development, sensitive periods and plasticity. The HPA connections and brain areas implicated in ELS and psychopathology are also explored. In a targeted review of HPA activation in mood and psychotic disorders, cortisol is generally elevated across mood and psychotic disorders. However, in bipolar disorder and psychosis patients with previous early life stress, blunted cortisol responses are found to awakening, psychological stressors and physiological manipulation compared to patients without previous early life stress. These attenuated responses occur in bipolar and psychosis patients on a background of increased cortisol turnover. Although cortisol measures are generally raised in depression, the evidence for a different HPA activation profile in those with early life stress is inconclusive. Further research is needed to explore the stress responses commonalities between bipolar disorder and psychosis in those patients with early life stress.
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Affiliation(s)
- Felim Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Anurag Nasa
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | | | - Kesidha Raajakesary
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Areej Gazzaz
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Vitallia Sooknarine
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Madeline Haines
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Elena Roman
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Linda Kelly
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Aisling O'Neill
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Darren William Roddy
- Department of Psychiatry, Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland
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White matter in prolonged glucocorticoid response to psychological stress in schizophrenia. Neuropsychopharmacology 2021; 46:2312-2319. [PMID: 34211106 PMCID: PMC8580975 DOI: 10.1038/s41386-021-01077-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 02/06/2023]
Abstract
Stress is implicated in psychosis etiology and exacerbation, but pathogenesis toward brain network alterations in schizophrenia remain unclear. White matter connects limbic and prefrontal regions responsible for stress response regulation, and white matter tissues are also vulnerable to glucocorticoid aberrancies. Using a novel psychological stressor task, we studied cortisol stress responses over time and white matter microstructural deficits in schizophrenia spectrum disorder (SSD). Cortisol was measured at baseline, 0-, 20-, and 40-min after distress induction by a psychological stressor task in 121 SSD patients and 117 healthy controls (HC). White matter microstructural integrity was measured by 64-direction diffusion tensor imaging. Fractional anisotropy (FA) in white matter tracts were related to cortisol responses and then compared to general patterns of white matter tract deficits in SSD identified by mega-analysis. Differences between 40-min post-stress and baseline, but not acute reactivity post-stress, was significantly elevated in SSD vs HC, time × diagnosis interaction F2.3,499.9 = 4.1, p = 0.013. All SSD white matter tracts were negatively associated with prolonged cortisol reactivity but all tracts were positively associated with prolonged cortisol reactivity in HC. Individual tracts most strongly associated with prolonged cortisol reactivity were also most impacted in schizophrenia in general as established by the largest schizophrenia white matter study (r = -0.56, p = 0.006). Challenged with psychological stress, SSD and HC mount similar cortisol responses, and impairments arise in the resolution timeframe. Prolonged cortisol elevations are associated with the white matter deficits in SSD, in a pattern previously associated with schizophrenia in general.
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4
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Cortisol as a Biomarker of Mental Disorder Severity. J Clin Med 2021; 10:jcm10215204. [PMID: 34768724 PMCID: PMC8584322 DOI: 10.3390/jcm10215204] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/28/2021] [Accepted: 11/04/2021] [Indexed: 01/19/2023] Open
Abstract
Cortisol—the most important steroid hormone with a significant effect on body metabolism—strongly affects peripheral tissues and the central nervous system. Fluctuations in cortisol secretion often accompany psychiatric disorders, and normalization of its levels correlates with improvement in the patient’s health. This indicates that cortisol may be useful as a biological marker that can help determine the likelihood of mental illness, its impending onset, and the severity of symptoms, which is especially important in the face of the increasing prevalence of mental disorders, including those associated with social isolation and anxiety during the COVID-19 pandemic. This publication reviews recent reports on cortisol levels in healthy participants and shows the current state of knowledge on changes in the levels of this hormone in people at risk for depression, bipolar disorder, and psychosis. It shows how people with psychiatric disorders react to stressful situations and how the applied therapies affect cortisol secretion. The influence of antidepressants and antipsychotics on cortisol levels in healthy people and those with mental disorders is also described. Finally, it reviews publications on the patterns of cortisol secretion in patients in remission.
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Rokita KI, Dauvermann MR, Mothersill D, Holleran L, Bhatnagar P, McNicholas Á, McKernan D, Morris DW, Kelly J, Hallahan B, McDonald C, Donohoe G. Current psychosocial stress, childhood trauma and cognition in patients with schizophrenia and healthy participants. Schizophr Res 2021; 237:115-121. [PMID: 34521038 DOI: 10.1016/j.schres.2021.08.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cognitive difficulties are experienced frequently in schizophrenia (SZ) and are strongly predictive of functional outcome. Although severity of cognitive difficulties has been robustly associated with early life adversity, whether and how they are affected by current stress is unknown. The present study investigated whether acute stress reactivity as measured by heart rate and mood changes predict cognitive performance in patients with schizophrenia and healthy individuals, and whether this is moderated by diagnosis and previous childhood trauma exposure. METHODS One hundred and four patients with schizophrenia and 207 healthy participants were administered a battery of tasks assessing cognitive performance after psychosocial stress induction (Trier Social Stress Test; TSST). Mood states (Profile of Mood States; POMS) and heart rate were assessed at baseline, immediately before, and after the TSST. RESULTS Both healthy participants and patients showed increases in POMS Tension and Total Mood Disturbance scores between Time Point 2 (pre-TSST) and Time Point 3 (post-TSST). These changes were not associated with variation in cognition. Although childhood trauma exposure was associated with higher stress reactivity and poorer cognitive function in all participants, childhood trauma did not moderate the association between stress reactivity and cognition. Neither was diagnosis a moderator of this relationship. DISCUSSION These findings suggest that while chronic stress exposure explains significant variation in cognition, acute stress reactivity (measured by changes in Tension and Total Mood Disturbance) did not. In the context of broader developmental processes, we conclude that stressful events that occur earlier in development, and with greater chronicity, are likely to be more strongly associated with cognitive variation than acute transient stressors experienced in adulthood.
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Affiliation(s)
- Karolina I Rokita
- School of Psychology, National University of Ireland Galway, Galway, Ireland; Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| | - Maria R Dauvermann
- School of Psychology, National University of Ireland Galway, Galway, Ireland; Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland; McGovern Institute for Brain Research, MIT, Cambridge, MA 02135, USA
| | - David Mothersill
- School of Psychology, National University of Ireland Galway, Galway, Ireland; Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland; School of Business, National College of Ireland, Dublin, Ireland
| | - Laurena Holleran
- School of Psychology, National University of Ireland Galway, Galway, Ireland; Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| | - Paridhi Bhatnagar
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Áine McNicholas
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Declan McKernan
- Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland; Pharmacology & Therapeutics, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Derek W Morris
- Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland
| | - John Kelly
- Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland; Pharmacology & Therapeutics, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Brian Hallahan
- Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland; Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
| | - Colm McDonald
- Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland; Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland
| | - Gary Donohoe
- School of Psychology, National University of Ireland Galway, Galway, Ireland; Centre for Neuroimaging, Cognition & Genomics, National University of Ireland Galway, Galway, Ireland.
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Quidé Y, Girshkin L, Watkeys OJ, Carr VJ, Green MJ. The relationship between cortisol reactivity and emotional brain function is differently moderated by childhood trauma, in bipolar disorder, schizophrenia and healthy individuals. Eur Arch Psychiatry Clin Neurosci 2021; 271:1089-1109. [PMID: 32926285 DOI: 10.1007/s00406-020-01190-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 08/21/2020] [Indexed: 01/01/2023]
Abstract
Childhood trauma is a risk factor for psychotic and mood disorders that is associated with abnormal hypothalamic-pituitary-adrenal (HPA) axis function in response to stress and abnormal social brain function. Here, we aimed to determine whether childhood trauma exposure would differently moderate associations between cortisol reactivity and social brain function, among cases with schizophrenia (SZ), bipolar disorder (BD) and in healthy individuals (HC). Forty cases with SZ, 35 with BD and 34 HCs underwent functional magnetic resonance imaging while performing an emotional face-matching task. Participants completed the Childhood Trauma Questionnaire and cortisol reactivity (i.e. the slope indexing the within-subject difference between pre- and post-imaging salivary cortisol levels) was determined. The severity of childhood trauma moderated the relationship between cortisol reactivity and brain activation in the bilateral temporo-parieto-insular junctions, right middle cingulum, right pre/postcentral gyri, left cerebellum and right lingual gyrus, differently depending on the clinical group. When exposed to high levels of trauma, the cortisol slope was negatively associated with activation in these regions in HC, while the cortisol slope was positively associated with activation in these regions in SZ cases. Similarly, there were differences between the groups in how trauma severity moderated the relationship between cortisol reactivity and functional connectivity between the amygdala and dorsolateral prefrontal cortex. In addition to reflecting typical associations between cortisol reactivity and emotional brain function when not exposed to childhood trauma, these findings provide new evidence that trauma exposure disrupts these relationships in both healthy individuals and in cases with SZ or BD.
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Affiliation(s)
- Yann Quidé
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia. .,Neuroscience Research Australia, Randwick, NSW, Australia.
| | - Leah Girshkin
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia.,Neuroscience Research Australia, Randwick, NSW, Australia
| | - Oliver J Watkeys
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia.,Neuroscience Research Australia, Randwick, NSW, Australia
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia.,Neuroscience Research Australia, Randwick, NSW, Australia.,Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Melissa J Green
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia.,Neuroscience Research Australia, Randwick, NSW, Australia
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7
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Lai CLJ, Lee DYH, Leung MOY. Childhood Adversities and Salivary Cortisol Responses to the Trier Social Stress Test: A Systematic Review of Studies Using the Children Trauma Questionnaire (CTQ). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010029. [PMID: 33374531 PMCID: PMC7793098 DOI: 10.3390/ijerph18010029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/19/2020] [Accepted: 12/20/2020] [Indexed: 12/27/2022]
Abstract
Alteration in cortisol response to acute social stressors has been hypothesized to mediate childhood adversities (CA) and increased morbidity in adulthood. However, the evidence supporting an association between CA and cortisol response to social stressors is inconclusive. The present review addressed this issue by reviewing the literature on CA and cortisol response to acute social stressors, with a focus on studies with adolescents or adults, using the Childhood Trauma Questionnaire (CTQ) to assess CA, and examining salivary cortisol response to the Trier Social Stress Test (TSST). Systematic searches of relevant articles in PsycINFO, PubMed, Web of Science and ScienceDirect in February and March 2020 identified 12 articles including 1196 participants with mean ages ranging from 15.3 to 52.3 yrs. across studies. CTQ scores were significantly associated with cortisol response in 2 studies. In addition, the physical abuse and emotional neglect subscales were associated with cortisol response respectively in 2 separate studies. The lack of association between CA and cortisol response calls for more longitudinal studies, and the use of formal records of maltreatment or informant reports in future research to complement information collected by retrospective measures. In addition, increased attention to biological mechanisms other than that associated with the regulation of cortisol in explaining the connection between CA and psychiatry morbidity is warranted.
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Affiliation(s)
- Chuk Ling Julian Lai
- Psychophysiology Laboratory, Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China; (D.Y.H.L.); (M.O.Y.L.)
- Correspondence: ; Tel.: +852-34424306; Fax: +852-34420283
| | - Daryl Yu Heng Lee
- Psychophysiology Laboratory, Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China; (D.Y.H.L.); (M.O.Y.L.)
- Department of Experimental Psychology, Division of Psychology and Language Sciences, University College London, London WC1H 0AP, UK
| | - Monique On Yee Leung
- Psychophysiology Laboratory, Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China; (D.Y.H.L.); (M.O.Y.L.)
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Farnia V, Farshchian F, Farshchian N, Alikhani M, Sadeghi Bahmani D, Brand S. Comparisons of Voxel-Based Morphometric Brain Volumes of Individuals with Methamphetamine-Induced Psychotic Disorder and Schizophrenia Spectrum Disorder and Healthy Controls. Neuropsychobiology 2020; 79:170-178. [PMID: 31794972 DOI: 10.1159/000504576] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/03/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Several psychological and neurological pathways are described to explain the emergence and maintenance of psychiatric disorders, and changes in brain volumes and brain activity are observed as correlates of psychiatric disorders. In the present study, we investigated if and to what extent specific voxel-based morphometric brain volume differences could be observed among individuals with methamphetamine-induced psychosis (MAIP) and schizophrenia spectrum disorder (SSD) compared to healthy controls. METHODS A total of 69 individuals took part in the present study. Of those, 26 were diagnosed with MAIP, 23 with SSD, and 20 were healthy controls. After a thorough psychiatric assessment, participants underwent brain volume measurement. RESULTS Compared to healthy controls, participants with MAIP had smaller volumes for left caudate and left and right parahippocampal gyrus. Compared to healthy controls, participants with SSD had smaller volumes for the gray and white matter, left amygdala, left hippocampus, left parahippocampal gyrus, left putamen, and the total volume. Compared to individuals with MAIP, individuals with SSD had a lower white matter brain volume. CONCLUSIONS The pattern of results suggests that individuals with MAIP and SSD showed specific and regional brain atrophies on the left hemisphere, always compared to healthy controls. Given the cross-sectional design, it remains undisclosed if specific and regional brain atrophies were the cause or the consequence of the psychiatric issues.
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Affiliation(s)
- Vahid Farnia
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Firoozeh Farshchian
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nazanin Farshchian
- Department of Radiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Alikhani
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Dena Sadeghi Bahmani
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress, and Sleep Disorders (ZASS), Basel, Switzerland.,Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Serge Brand
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran, .,University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress, and Sleep Disorders (ZASS), Basel, Switzerland, .,University of Basel, Department of Sport, Exercise, and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland,
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9
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Comer AL, Carrier M, Tremblay MÈ, Cruz-Martín A. The Inflamed Brain in Schizophrenia: The Convergence of Genetic and Environmental Risk Factors That Lead to Uncontrolled Neuroinflammation. Front Cell Neurosci 2020; 14:274. [PMID: 33061891 PMCID: PMC7518314 DOI: 10.3389/fncel.2020.00274] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022] Open
Abstract
Schizophrenia is a disorder with a heterogeneous etiology involving complex interplay between genetic and environmental risk factors. The immune system is now known to play vital roles in nervous system function and pathology through regulating neuronal and glial development, synaptic plasticity, and behavior. In this regard, the immune system is positioned as a common link between the seemingly diverse genetic and environmental risk factors for schizophrenia. Synthesizing information about how the immune-brain axis is affected by multiple factors and how these factors might interact in schizophrenia is necessary to better understand the pathogenesis of this disease. Such knowledge will aid in the development of more translatable animal models that may lead to effective therapeutic interventions. Here, we provide an overview of the genetic risk factors for schizophrenia that modulate immune function. We also explore environmental factors for schizophrenia including exposure to pollution, gut dysbiosis, maternal immune activation and early-life stress, and how the consequences of these risk factors are linked to microglial function and dysfunction. We also propose that morphological and signaling deficits of the blood-brain barrier, as observed in some individuals with schizophrenia, can act as a gateway between peripheral and central nervous system inflammation, thus affecting microglia in their essential functions. Finally, we describe the diverse roles that microglia play in response to neuroinflammation and their impact on brain development and homeostasis, as well as schizophrenia pathophysiology.
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Affiliation(s)
- Ashley L. Comer
- Graduate Program for Neuroscience, Boston University, Boston, MA, United States
- Department of Biology, Boston University, Boston, MA, United States
- Neurophotonics Center, Boston University, Boston, MA, United States
- Center for Systems Neuroscience, Boston University, Boston, MA, United States
| | - Micaël Carrier
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Québec City, QC, Canada
| | - Marie-Ève Tremblay
- Axe Neurosciences, Centre de Recherche du CHU de Québec, Université Laval, Québec City, QC, Canada
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
- Department of Biochemistry and Molecular Biology, The University of British Columbia, Vancouver, BC, Canada
| | - Alberto Cruz-Martín
- Graduate Program for Neuroscience, Boston University, Boston, MA, United States
- Department of Biology, Boston University, Boston, MA, United States
- Neurophotonics Center, Boston University, Boston, MA, United States
- Center for Systems Neuroscience, Boston University, Boston, MA, United States
- Department of Pharmacology and Experimental Therapeutics, Boston University, Boston, MA, United States
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10
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Bastos MAV, Bastos PRHDO, e Paez LEF, de Souza EO, Bogo D, Perdomo RT, Portella RB, Ozaki JGO, Iandoli D, Lucchetti G. "Seat of the soul"? The structure and function of the pineal gland in women with alleged spirit possession-Results of two experimental studies. Brain Behav 2020; 10:e01693. [PMID: 32506697 PMCID: PMC7375051 DOI: 10.1002/brb3.1693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/04/2020] [Accepted: 05/12/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Cultural traditions attribute to pineal gland an important role for spiritual experiences. Mediumship and spirit possession are cultural phenomena found worldwide which have been described as having dissociative and psychotic-like characteristics, but with nonpathological aspects. A sympathetic activation pattern in response to spirit possession has been reported in some studies, but empirical data on pineal gland is scarce in this context. METHODS We aimed to investigate pineal gland and pituitary volumes, as well as urinary 6-sulfatoxymelatonin levels in 16 alleged mediums (Medium Group-MG) compared with 16 healthy nonmedium controls (Control Group) (Experiment 1). Furthermore, we aimed to evaluate urinary 6-sulfatoxymelatonin and stress reactivity in GM (n = 10) under different physiological conditions (Experiment 2). RESULTS In Experiment 1, MG presented higher scores of anomalous experiences, but there were no between-group differences regarding mental health or subjective sleep quality. Similar pineal gland and pituitary volumes were observed between groups. There were no between-group differences in urinary 6-sulfatoxymelatonin collected under equivalent baseline conditions. In Experiment 2, the rise of anxiety and heart rate in response to mediumistic experience was intermediate between a nonstressful control task (reading) and a stressful control task (Trier Social Stress Test-TSST). No significant differences were observed in 6-sulfatoxymelatonin urinary levels between the three conditions. The pattern of stress reactivity during the TSST was normal, but with an attenuated salivary cortisol response. CONCLUSION The normal neuroimaging and stress reactivity findings in MG contrast with the abnormal results usually observed in subjects with psychotic and dissociative disorders.
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Affiliation(s)
| | | | | | | | - Danielle Bogo
- School of Pharmaceutical SciencesFederal University of Mato Grosso do SulCampo GrandeBrazil
| | - Renata Trentin Perdomo
- School of Pharmaceutical SciencesFederal University of Mato Grosso do SulCampo GrandeBrazil
| | | | | | - Décio Iandoli
- School of MedicineAnhanguera‐Uniderp UniversityCampo GrandeBrazil
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Zhang A, Price JL, Leonard D, North CS, Suris A, Javors MA, Adinoff B. Alcohol Use Disorder Masks the Effects of Childhood Adversity, Lifetime Trauma, and Chronic Stress on Hypothalamic-Pituitary-Adrenal Axis Reactivity. Alcohol Clin Exp Res 2020; 44:1192-1203. [PMID: 32491213 DOI: 10.1111/acer.14334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/28/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Individuals with alcohol use disorder (AUD) and those who have experienced traumas or chronic stress exhibit dysregulated hypothalamic-pituitary-adrenal (HPA) axis reactivity. Whether and how trauma and stress histories interact with AUD to affect HPA axis reactivity has not been assessed. METHODS In the present study, 26 healthy male controls and 70 abstinent men with AUD were administered a pharmacologic probe [ovine corticotropin-releasing hormone (oCRH)] and psychosocial stressor to assess HPA axis reactivity. Plasma adrenocorticotropin hormone (ACTH) and cortisol were assessed every 10-20 minutes. Hierarchical clustering of multiple measures of trauma and stress identified 3 distinct clusters: childhood adversity, lifetime trauma, and chronic stress. General linear model procedures were used to examine main effects of group (AUD/control) and interaction effects of the 3 clusters upon net-integrated ACTH and cortisol response. RESULTS We found that higher levels of childhood adversity, lifetime trauma, and chronic stress were each associated with blunted oCRH-induced ACTH reactivity in controls, but not in the AUD group. Recent chronic stress within the prior 6 months had the strongest influence upon ACTH reactivity in the control group, and lifetime trauma, the least. CONCLUSIONS Childhood adversity, lifetime trauma, and chronic stress likely exert persistent, measurable effects upon HPA axis functioning in healthy controls. This association appears to be masked in individuals with AUD, potentially confounding studies examining the effects of stress, adversity, and/or trauma upon the HPA axis in this population during the protracted withdrawal phase of recovery. Future work targeting stress exposure and reactivity should consider the heightened effect of previous alcohol use relative to past adversity and trauma.
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Affiliation(s)
- Alice Zhang
- From the, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Julianne L Price
- Department of Psychology, University of Florida, Gainesville, Florida.,Department of Psychiatry, University of Florida, Gainesville, Florida
| | - David Leonard
- David Leonard Statistical Consulting, Wichita Falls, Texas
| | - Carol S North
- From the, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Alina Suris
- From the, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas.,Mental Health, VA North Texas Health Care System, Dallas, Texas
| | - Martin A Javors
- Departments of Psychiatry and Pharmacology, University of Texas Health Science Center-San Antonio, San Antonio, Texas
| | - Bryon Adinoff
- From the, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas.,Mental Health, VA North Texas Health Care System, Dallas, Texas.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado
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12
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Imani MM, Sadeghi M, Khazaie H, Sanjabi A, Brand S, Brühl A, Sadeghi Bahmani D. Associations Between Morning Salivary and Blood Cortisol Concentrations in Individuals With Obstructive Sleep Apnea Syndrome: A Meta-Analysis. Front Endocrinol (Lausanne) 2020; 11:568823. [PMID: 33542703 PMCID: PMC7851085 DOI: 10.3389/fendo.2020.568823] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/24/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS) may be associated with an increase in hypothalamic-pituitary-adrenocortical axis activity (HPA AA). We reviewed research comparing morning salivary and blood (serum and plasma) cortisol concentrations of individuals with OSAS to those of healthy controls. METHODS We made a systematic search without any restrictions of the PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases for relevant articles published up to August 25, 2019. RESULTS Sixteen studies were analyzed in this meta-analysis; five studies compared morning salivary concentrations, five compared serum concentrations, four compared plasma cortisol concentrations, and two compared both salivary and plasma concentrations. In pediatric samples, compared to healthy controls, those with OSAS had significantly lower saliva morning cortisol concentrations (MD = -0.13 µg/dl; 95% CI: 0.21, -0.04; P = 0.003). In contrast, no significant differences were observed for serum cortisol concentrations, plasma cortisol concentrations, or salivary morning cortisol concentrations between adults with and without OSAS (p = 0.61, p = 0.17, p = 0.17). CONCLUSION Cortisol concentrations did not differ between adults with OSAS and healthy controls. In contrast, morning salivary cortisol concentrations were lower in children with OSAS, compared to healthy controls. Given that a reduced HPA AA is observed among individuals with chronic stress, it is conceivable that children with OSAS are experiencing chronic psychophysiological stress.
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Affiliation(s)
- Mohammad Moslem Imani
- Kermanshah University of Medical Sciences, Department of Orthodontics, Kermanshah, Iran
| | - Masoud Sadeghi
- Kermanshah University of Medical Sciences, Medical Biology Research Center, Kermanshah, Iran
| | - Habibolah Khazaie
- Kermanshah University of Medical Sciences, Sleep Disorders Research Center, Kermanshah, Iran
| | - Arezoo Sanjabi
- Kermanshah University of Medical Sciences, Students Research Committee, Kermanshah, Iran
| | - Serge Brand
- Kermanshah University of Medical Sciences, Sleep Disorders Research Center, Kermanshah, Iran
- University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland
- University of Basel, Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland
- Kermanshah University of Medical Sciences, Substance Abuse Prevention Research Center, Kermanshah, Iran
- Tehran University of Medical Sciences, School of Medicine, Tehran, Iran
- *Correspondence: Serge Brand,
| | - Annette Brühl
- University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland
| | - Dena Sadeghi Bahmani
- Kermanshah University of Medical Sciences, Sleep Disorders Research Center, Kermanshah, Iran
- University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland
- Kermanshah University of Medical Sciences, Substance Abuse Prevention Research Center, Kermanshah, Iran
- University of Basel, Psychiatric Clinics, Old Age Department, Basel, Switzerland
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13
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Yang F, Cao X, Sun X, Wen H, Qiu J, Xiao H. Hair Cortisol Is Associated With Social Support and Symptoms in Schizophrenia. Front Psychiatry 2020; 11:572656. [PMID: 33192700 PMCID: PMC7541838 DOI: 10.3389/fpsyt.2020.572656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Psychosocial stressors may worsen psychotic symptoms in schizophrenia, while social support could protect against the effects of stress in schizophrenia. Hypothalamus-pituitary-adrenal axis dysfunction has been associated with schizophrenia. Hair cortisol concentrations (HCC) allow assessment of cumulative cortisol secretion over the preceding 3 months. The relationship between HCC, psychosocial stressors, social support, and the clinical characteristics of schizophrenia needs to be explored. METHODS One hundred nine schizophrenia patients and 86 healthy controls between the ages of 18 and 60 were enrolled in the study. Three-centimeter samples of hair were collected from the scalp and HCC were measured using ELISA kits. Linear regression and factor analysis were employed to examine the relationship between HCC, childhood trauma, the number of stressful life events (SLE), the amount of social support in the 3 months prior to the hair cortisol assessment and clinical characteristics of schizophrenia. RESULTS Schizophrenia patients experience more SLE in their lifetime, receive less social support, and have lower HCC in the recent 3 months compared to healthy controls. In the schizophrenia patients, HCC are positively associated with the amount of social support and negatively associated with the severity of delusions. The interaction between social support and SLE predicts decreased HCC. Factor analysis shows that a subgroup of schizophrenia patients who experience childhood trauma and SLE are characterized by decreased HCC. CONCLUSIONS Findings indicate social support could be a moderator for the relationship between SLE and HCC which may attenuate the effects of SLE in schizophrenia.
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Affiliation(s)
- Fuzhong Yang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xinyi Cao
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiujia Sun
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hui Wen
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jianyin Qiu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hua Xiao
- State Key Laboratory of Microbial Metabolism, Joint International Research Laboratory of Metabolic & Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
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14
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Cortisol stress response in psychosis from the high-risk to the chronic stage: a systematic review. Ir J Psychol Med 2019; 36:305-315. [PMID: 31317845 DOI: 10.1017/ipm.2019.27] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES We review studies of whether cortisol levels following psychosocial stress exposure differ between patients with psychosis and healthy control subjects. METHODS Original research published between 1993 and February 2019 was included in the literature search. Studies that used experimentally induced psychosocial stress and reported stress response measures of plasma or saliva cortisol levels in patients at any stage of illness (i.e. high risk, first episode and chronic phase) were included. RESULTS A total of 17 studies were included. Although there was evidence of inconsistencies in measures, we observed moderate evidence of an association with stress-induced cortisol blunting response across studies. CONCLUSIONS This review highlights recent evidence of blunting of cortisol response following experimentally induced psychosocial stress. While there was some evidence of this blunted response across illness types and stages, the strongest evidence was observed for those with chronic schizophrenia. Due to the low number of studies, in particular in bipolar disorder, much work is still needed to accurately characterise the biological effects of stress in psychosis.
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15
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Seitz R, Vracotas N, Bechard-Evans L, King S, Abadi S, Joober R, Shah JL, Malla AK, Pruessner M. The Trier Social Stress Test in first episode psychosis patients: Impact of perceived stress, protective factors and childhood trauma. Psychoneuroendocrinology 2019; 105:155-163. [PMID: 30658856 DOI: 10.1016/j.psyneuen.2019.01.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 01/06/2019] [Accepted: 01/10/2019] [Indexed: 11/17/2022]
Abstract
Psychosis has been associated with abnormalities in hypothalamic-pituitary-adrenal axis functioning, which may emerge through heightened stress sensitivity following early life adversity - ultimately resulting in illness onset and progression. The present study assessed cortisol levels during an established psychosocial stress task and their association with current stress perception, putative protective factors and adverse childhood experiences in patients with a first episode of psychosis (FEP). A total of 100 volunteers participated in the study, 57 of whom were patients with a FEP (mean age 23.9 ± 3.8) and 43 healthy community controls (mean age 23.2 ± 3.9). Salivary cortisol, heart rate and blood pressure were measured at eight time points before and after the Trier Social Stress Test. Subjective stress and protective factors were assessed with the Perceived Stress Scale, the Self-Esteem Rating Scale and the Brief COPE. Early life adversity was assessed with the Childhood Trauma Questionnaire. Patients compared to controls showed significantly lower cortisol levels (F = 7.38; p = .008) throughout the afternoon testing period, but no difference in the cortisol response to the TSST. Heart rate was elevated and protective factors were lower in patients compared to controls. Attenuated cortisol levels were associated with higher levels of perceived stress, poor protective factors and more physical neglect during childhood. Our results suggest that attenuated baseline cortisol levels and not a blunted response during an acute stress task might be an indicator of heightened stress vulnerability and poor resilience in psychosis. The possible influence of childhood adversity and antipsychotic medication is discussed.
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Affiliation(s)
- Raffaela Seitz
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Nadia Vracotas
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Laura Bechard-Evans
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Suzanne King
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Sherezad Abadi
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Ridha Joober
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Jai L Shah
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Ashok K Malla
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Marita Pruessner
- Department of Psychology, University of Konstanz, Konstanz, Germany; Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada.
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16
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Ciufolini S, Gayer-Anderson C, Fisher HL, Marques TR, Taylor H, Di Forti M, Zunszain P, Morgan C, Murray RM, Pariante CM, Dazzan P, Mondelli V. Cortisol awakening response is decreased in patients with first-episode psychosis and increased in healthy controls with a history of severe childhood abuse. Schizophr Res 2019; 205:38-44. [PMID: 29776641 DOI: 10.1016/j.schres.2018.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/30/2018] [Accepted: 05/04/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Childhood abuse is highly prevalent in psychosis patients, but whether/how it affects hypothalamic-pituitary-adrenal (HPA) axis at the onset of psychosis remains unclear. We aimed to investigate the effects of severity of childhood abuse on HPA axis activity, in first-episode psychosis (FEP) and healthy controls. METHODS We recruited 169 FEP patients and 133 controls with different degrees of childhood physical and sexual abuse (i.e. no abuse exposure, non-severe abuse exposure, and severe abuse exposure). Saliva samples were collected to measure cortisol awakening response with respect to ground (CARg), increase (CARi) and diurnal (CDD) cortisol levels. Two-way ANOVA analyses were conducted to test the relationships between severity of childhood abuse and psychosis on cortisol levels in individuals with psychosis and healthy controls with and without childhood abuse history. RESULTS A statistically significant interaction between childhood abuse and psychosis on CARg was found (F(2,262) = 4.60, p = 0.011, ω2 = 0.42). Overall, controls showed a U-shaped relationship between abuse exposure and CARg, while patients showed an inverted U-shaped relationship. CARg values were markedly different between patients and controls with either no abuse history or exposure to severe childhood abuse. No significant differences were found when looking at CARi and CDD. CONCLUSIONS Our results show a divergent effect of severe childhood abuse on HPA axis activity in patients with first-episode psychosis and in controls. In the presence of exposure to severe childhood abuse, a blunted CARg and a less reactive HPA axis may represent one of the biological mechanisms involved in the development of psychosis.
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Affiliation(s)
- Simone Ciufolini
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, London, UK; National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, UK
| | - Charlotte Gayer-Anderson
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Health Services & Population Research, London, UK
| | - Helen L Fisher
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Social, Genetic & Developmental Psychiatry Centre, London, UK
| | - Tiago Reis Marques
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, London, UK
| | - Heather Taylor
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, London, UK
| | - Marta Di Forti
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Social, Genetic & Developmental Psychiatry Centre, London, UK
| | - Patricia Zunszain
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, London, UK
| | - Craig Morgan
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Health Services & Population Research, London, UK
| | - Robin M Murray
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, London, UK
| | - Carmine M Pariante
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, London, UK; National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, UK
| | - Paola Dazzan
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, London, UK; National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, UK
| | - Valeria Mondelli
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychological Medicine, London, UK; National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, UK.
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17
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Luhrmann TM, Alderson-Day B, Bell V, Bless JJ, Corlett P, Hugdahl K, Jones N, Larøi F, Moseley P, Padmavati R, Peters E, Powers AR, Waters F. Beyond Trauma: A Multiple Pathways Approach to Auditory Hallucinations in Clinical and Nonclinical Populations. Schizophr Bull 2019; 45:S24-S31. [PMID: 30715545 PMCID: PMC6357973 DOI: 10.1093/schbul/sby110] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
That trauma can play a significant role in the onset and maintenance of voice-hearing is one of the most striking and important developments in the recent study of psychosis. Yet the finding that trauma increases the risk for hallucination and for psychosis is quite different from the claim that trauma is necessary for either to occur. Trauma is often but not always associated with voice-hearing in populations with psychosis; voice-hearing is sometimes associated with willful training and cultivation in nonclinical populations. This article uses ethnographic data among other data to explore the possibility of multiple pathways to voice-hearing for clinical and nonclinical individuals whose voices are not due to known etiological factors such as drugs, sensory deprivation, epilepsy, and so forth. We suggest that trauma sometimes plays a major role in hallucinations, sometimes a minor role, and sometimes no role at all. Our work also finds seemingly distinct phenomenological patterns for voice-hearing, which may reflect the different salience of trauma for those who hear voices.
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Affiliation(s)
- Tanya Marie Luhrmann
- Department of Anthropology, Stanford University, Stanford, CA,To whom correspondence should be addressed; Department of Anthropology, Stanford University, Building 50, Stanford, CA 94305, USA; tel.: 650-723-3421, fax: 650-725-0605, e-mail:
| | | | - Vaughan Bell
- Division of Psychiatry, University College London, London, UK
| | - Josef J Bless
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Philip Corlett
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway,Department of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Nev Jones
- Department of Mental Health Law and Policy, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL
| | - Frank Larøi
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway,Norwegian Center of Excellence for Mental Disorders Research, University of Oslo, Oslo, Norway,Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
| | - Peter Moseley
- Department of Psychology, Durham University, Durham, UK,School of Psychology, University of Central Lancashire, Preston, UK
| | | | - Emmanuelle Peters
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, London, UK,Psychological Interventions Clinic for Outpatients with Psychosis, South London and Maudsley NHS Foundation Trust (SLaM), London, England, UK
| | - Albert R Powers
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Flavie Waters
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia,Clinical Research Centre, Graylands Health Campus, North Metropolitan Health Service, Mental Health, Nedlands, Western Australia, Australia
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18
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Social brain, social dysfunction and social withdrawal. Neurosci Biobehav Rev 2019; 97:10-33. [DOI: 10.1016/j.neubiorev.2018.09.012] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 05/31/2018] [Accepted: 09/17/2018] [Indexed: 01/07/2023]
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19
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Letter to the Editor "Childhood maltreatment severity is associated with elevated C-reactive protein and body mass index in adult with schizophrenia and bipolar diagnoses". Brain Behav Immun 2017; 65:362. [PMID: 28698117 DOI: 10.1016/j.bbi.2017.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 07/08/2017] [Indexed: 11/21/2022] Open
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